What Is Your Billing Policy?

You will receive a bill directly from Oral Pathology Associates, Inc. for our service, which is separate from the fee charged by your surgeon. In the case of multiple sites, each site will have a separate fee. Decalcification of hard tissue such as bone, evaluation of margins, and special stains entail additional charges.

As a courtesy to you, we will bill medical or dental insurance companies for reimbursement to the insured for our services.  Please note, that is the responsibility of the patient to provide our office with complete and accurate insurance information so we can submit a claim on your behalf.

Claims will ONLY be submitted when complete and accurate insurance information is received.  HMO plans will not cover our charges and we are not Medicare providers. We have opted out of Medicare. Payments from PPO dental and medical plans vary depending upon your coverage and eligibility of benefits. Most insurance companies will reimburse the insured directly, since we are not members of any of the preferred provider networks.  Most insurance companies will reimburse the subscriber directly since this laboratory is not a member of any preferred provider networks.  If the insurance company payment is sent to us in error, a reimbursement will be sent to the subscriber.

You are responsible for this account regardless of insurance and it should be paid promptly. We accept personal and certified checks, as well as Visa, Mastercard and American Express. Please do not send cash. If you are paying by credit card, please be sure the cardholder’s name is legible, and provide us with the billing address for the card if it is different from the patient address on your statement.

Did The Doctor Send The Necessary Insurance Information?

On occasion, doctor’s staff will not provide us with your complete insurance information. With your billing statement, we provide instructions and a return envelope for you to mail copies of your insurance card(s). We will process your claim immediately upon receipt of your insurance information. In the meantime, you are responsible for paying the bill in full. Most insurance plans will reimburse you directly for all or part of the bill depending upon your coverage.

Do I Need to Send in Full Payment Even Through An Insurance Claim Is Being Processed?

Yes, as a rule we do not receive payments from insurance carriers since we are out of network providers. Most of the time insurance payments are made directly to our patients. As a consequence, it is important that we receive payment from our patients as soon as is possible.

What Is The Status of My Biopsy Report?

Information concerning the biopsy report is obtained from the doctor performing the biopsy.

Processing of routine biopsy specimens begin upon arrival in this office. Usually, the specimen is available for our pathologist’s review the next day. The biopsy report is finalized on the same or next day. The report is faxed to the doctor upon completion. The original report is mailed to the doctor the same day it was faxed.

In summary, biopsy reports usually arrive at the doctor’s office within three days of our receiving the specimen. This timetable may be extended if the doctor taking the biopsy does not immediately mail the specimen or if special processing is necessary.

What Was The Diagnosis of My Condition?

It is appropriate for your treating doctor to provide you with the diagnosis and answer all questions you may have.

What If My Doctor Needs Additional Information About The Report?

Our pathologists are available to discuss the report and the diagnosis with the doctor submitting the biopsy. When a doctor calls, our staff immediately retrieves the report and has it in the hands of the pathologist taking the call. Drs. Boros and Melrose spend many hours each week in such consultations.